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NL 2018/06

The Undervalued Pregnancy Test

“Hold the tip of the test strip in your urine stream. Read the result after 5 minutes.” Easy as pie. Utterly trivial. Completely apolitical.

While sociologists, demographers and even theologians concerned themselves at length with the impact the ‘pill’ had in terms of changing society, the explosively political development of the pregnancy test has attracted little attention until now. We have the British historian of science Jesse Olszynko-Gryn, from the University of Cambridge, to thank for the fact that this topic is now coming to light.

Why women should even know that they are pregnant at all is something that German Prof. Walter Stoeckel was still asking in 1943. In his textbook on obstetrics, he writes: “If, when first examining a woman, one is not sure whether she is pregnant or not, one would do well to call the woman for another examination after 14 days or 3 weeks. […] For tactical reasons too, it is sometimes advisable to not necessarily share the diagnosis at the very first examination, for example, in the case of unmarried women for whom one has reason to believe pregnancy would be unwelcome.”

In the background loomed the fear that, armed with this knowledge, women would ‘get silly ideas’.

There were two mechanisms to act as a safeguard against any possible ‘silly ideas’: firstly, there was an enactment stating that a woman had to report her pregnancy to the priest or lord of the manor, otherwise she was classed as a (potential) child murderer, and made herself liable to prosecution. Secondly, several people were involved in the (early) determination of a pregnancy, meaning that the woman could no longer terminate her pregnancy without others knowing.

The first reliable pregnancy tests (c. 1920 to c. 1960) actually demanded a great deal in terms of staffing resources, organisational effort and costs; so, it is understandable that one endeavoured to keep them within the medical industry and to limit them to the investigation of diagnostic and therapeutic questions. The newly developed immunological tests were certainly significantly easier to implement and considerably cheaper, due to their industrial production, but they remained in the hands of ‘experts’ (doctors, pharmacists, the national health care system).

Medical reasons for increased demand

The demand for knowing in good time about an existing pregnancy began to grow in the 1960s. Key issues here were the thalidomide disaster, an awareness of the possibility of acquiring a rubella infection, the damage caused to a foetus by smoking and alcohol, but also the improved treatment possibilities for those who wanted children but could not have them. Pregnancy tests gradually came to be offered by various health providers. Yet women were still dependent on the knowledge of third parties.

With the ‘predictor’, the first do-it-yourself pregnancy test came onto the market in Great Britain in 1971, but there were also warnings about unreliable tests or (costly) application errors.

The turnaround came when women’s organisations realised, in the course of their fight for free contraception and liberalisation of abortion, that the power to decide would lie in the hands of the doctor and not the woman so long as pregnancy tests remained a medical service. Activists learned how to operate the commercial tests, fought against the manufacturers’ refusal to deliver test kits to non-medical institutions, developed advice services, and won doctors over for help. The pregnancy test had turned into a tool in the fight for women’s emancipation.

In contrast to today, the first modern test kits still resembled a small chemistry lab, with instructions drafted accordingly. Technical terms like “agglutination” needed to be rendered in generally understood language, and the entire manual adapted for use in women’s centres. It was also a case of finding free premises with a water connection and lavatories, organising fridges for storing the test kits, training volunteer testers, and developing and fine-tuning quality standards.

Feminist pregnancy tests up until the 1980s

How was the test result to be communicated to the woman in question? The basic assumption that only women who feared pregnancy would request a test soon had to be revised. And so, the initial “You are not pregnant” was changed to a neutral “The test is negative.” The question initially posed of “What contraception do you use?” was also abandoned, because it made no sense in the case of a planned pregnancy. An additional learning process the activists had to go through concerned caring for women who – for whatever reason – broke into tears after being told the test result. And lastly, organisational measures needed to be taken to ensure the women’s centres could guarantee privacy and confidentiality for their clients.

But it was also a matter of introducing the offer of inexpensive pregnancy testing to circles not among those who regularly participated in women’s meetings, and, ultimately, the political battle had to be continued, so that the public health providers would expand their offering in terms of pregnancy tests, instead of trying to wriggle out of this, delighted – because it saved costs – to relinquish this matter to the activists.

The science historian Jesse Olszynko-Gryn conducted interviews with many pioneers of the women’s movement, and in his very gripping and detailed work ‘The feminist appropriation of pregnancy testing in 1970s Britain’, he describes their difficult path to ‘conquering’ the pregnancy test. Thanks to their political work, they have demystified the medicine in this area and empowered women by strengthening their autonomy. We have them to thank for the fact that the medical technology of pregnancy tests has entered into the sphere of the private household.

We no longer know it any other way: Easy as pie. Utterly trivial. Completely apolitical.

An interesting article about pregnancy test also appeared in the current ‘Deutschen Apotheker Zeitung' (158th Jg, No. 21, May 24, 2018, page 48).